A World Without Permanent Hair Removal

By the 19th century, doctors had determined that hair grew from a bulb at the base of the hair follicle and that damaging the heart of the bulb, the germinal papilla, could often stop the hair regrowing permanently.

How to do this was the gruesome part. Methods included injecting carbolic acid with a hypodermic syringe, inserting and then twisting a barbed needle or inserting a smooth needle heated until it glowed red-hot. Like other medical procedures of the day such as blood transfusions which would sometimes work brilliantly and sometimes kill the patient (blood groups were unknown), doctors knew enough to know what needed to be done but not enough to do it reliably.

Needless to say, attempts at permanent hair removal at this time were not done for cosmetic reasons – only out of medical necessity. Ophthalmologists, for instance, were keen to find a way to permanently remove ingrown eyelashes. Ingrown eyelashes were more than a nuisance. Allowed to fester, they would irritate the eye to the point of chronic inflammation and eventual blindness.

1875: Electrolysis Invented

Doctor Charles Michel

Doctor Charles Michel

Doctor Charles Michel was a field surgeon in the Confederate Army during the American Civil War and was no stranger to the trauma of battle wounds. As an ophthalmologist, he had little hesitation practising the macabre methods of eyelash removal previously mentioned. The scarring and wound reactions this left, however, led Doctor Michel to look for another way.

Just as laser is seen as a “trendy” medical technology today, in the 19th century it was electricity being experimented with as the universal cure. This medical fervour set the scene for Mary Shelley’s famous novel of resurrection via the power of electricity: Frankenstein. “Perhaps a corpse would be re-animated. Galvanism had given token of such things”, Mary wrote the night before sharing the story.

Doctor Michel had heard of the surgical process of chemical decomposition through electricity known as electrolysis and experimented with modifying it to develop a suitable technique for use on eyelashes. He placed a metal plate against the patient’s cheek connected to the positive electrode of a galvanic cell (battery), inserted a needle connected to the negative electrode into the follicle and applied a current. The hair then came away easily with tweezers. The mechanism of the hair follicle was found to have been destroyed by the caustic sodium hydroxide produced by the electro-chemical reaction to the extent that the hair would not regrow.

After perfecting his technique on eyelashes, Doctor Michel tried his hand at cosmetic surgery by applying it to eyebrows. He published a report detailing his electrochemical decomposition of hair follicles in the St. Louis Clinical Record in 1875.

1880 – 1900: Electrolysis Adopted for Non-medical Use

The editor of this publication, Dermatologist William Hardaway, was impressed and tried the technique in his own practice on patients with excess body hair. He presented his results at the second meeting of the American Dermatological Association. It is worth quoting the notes of an attendee at this meeting as it illustrates the timelessness of both the problem and the cure:

“We know nothing of Miss X save what her physician, WA Hardaway, recorded in 1877. 22 years old when she came under Dr Hardaway’s care, Miss X was thoroughly feminine in character and physique, nicely plump and robustly healthy. She was also the unfortunate owner of a beard that for strength and luxuriance rivalled the hirsute appendages of any man. Previous efforts to remove her beard had not gone well: after the application of depilatory powder the beard grew back thicker and more profuse than before. Eager to be of service to the young woman, Hardaway decided to tackle the luxuriant but unwanted beard with an experimental procedure: electrolysis. Moving strand by strand in this fashion, Hardaway and a colleague removed the entirety of Miss X’s appendage. The two men worked on the young woman’s face for an hour or two at each session; as many as nine sessions per week; more than 350 treatments in total. Despite the procedure’s tedium, Hardaway concluded that this radical cure of hirsuties (sic) is brilliant in its results.”

Use of the technique spread quickly in medical circles. In 1889 one Detroit doctor reported treating over 1,500 cases of superfluous hair with electrolysis. On the other hand, many doctors saw electrolysis as an ephemeral beauty treatment since, while it may have been socially debilitating, there was nothing life-threatening about being hairy but as long as equipment to undertake electrolysis had to be built by the practitioner, the process remained firmly in the hands of those doctors prepared to do so.

1900: First Commercial Electrolysis Machines

Early Electrolysis Kit

Early Electrolysis Kit

By the turn of the 20th century, the first manufactured electrolysis kits were appearing on the market. Suppliers were careful to include detailed instruction manuals outlining the hair removal process as well as machine operation knowing they would have to create a market outside the medical profession to sell the machines profitably. One company from this era, Instantron of Rhode Island, survives to this day.

Soon hair removal moved out of the hands of doctors and was practised by barbers, hairdressers and beauty salons across the USA, the UK and Australia. In parts of Europe this was not the case. Where the US and UK had gone down the path of licensing operators, France and others countries banned the use of electrolysis outside of the medical profession.

The choice to ban or limit electrolysis was not without merit. Hasty and untrained operators would attempt to speed the process and cut corners by applying too much current, using unsterile probes or giving incorrect aftercare instructions. The result was burns, scars and infection.

Licensing in the US and UK, however, resulted in scientifically-based courses and associations of electrologists to uphold the reputation of the industry leaving electrologists with more specific knowledge and skill than their medically trained counterparts in Europe.

1908: Multi-probe Electrolysis Invented

Early multi-probe Electrolysis

Early multi-probe Electrolysis

In spite of these restrictions, the big innovation in electrolysis came from Germany, not the USA. In 1908, dermatologist Ernst Kromayer saw no reason why electrolysis should be performed one hair at a time with the ensuing wait for enough sodium hydroxide to form before moving on to the next hair. Why not simply employ multiple probes? Of course, at this time multiple probes meant multiple probes at the same time – not consecutively as practised today. Without individually regulated power to each probe and separate timers it was simply impossible to run varying numbers of probes at once without the risk of concentrating too much current or leaving some probes in too long. Even this form of multi-probe, however, was a mighty leap forward in efficiency.

Multi-probe electrolysis now brought the treatment into the mass market. Operators could charge between $6 – $10 an hour in the 1920s which was more than a day’s pay for many workers, but multi-probe meant the treatment was at least within reach of those desperate enough.

Limitations of Early Multi-probe Electrolysis

The introduction of multi-probe electrolysis machines had a significant effect on discomfort. Working one hair at a time was easy to tolerate at any current level – 8 or more probes at once was not! This led to the popularity of topical anaesthetics containing cocaine to ease discomfort. Overdosing on the anaesthetic produced some unusual side-effects.

The probes themselves were also an ongoing problem. Highly conductive platinum and gold needles were expensive and deteriorated with constant use. Steel was preferred but even these probes were too expensive to throw away after each use. They were also much thinner than today’s high-strength stainless steel probes and, to cut costs even further; it was not uncommon to substitute sewing machine needles for custom electrolysis probes. All this meant operators needed even more skill than today in order to insert needles without bruising or breaking the skin.

Today’s machines regulate the current distributed to each probe gradually increasing current at the beginning of each insertion and tapering it off at the end. Early machines had no such ability and operators tried all sorts of innovations to ease the jarring sensation of current start-up. A common method was to connect each of the batteries supplying the current in stages and to have the client slowly remove their hand from the saline solution used to complete the circuit before the current was switched off.

Dangerous Alternatives

X-Ray Hair Removal Machine

X-Ray Hair Removal Machine

Because of the high cost and long duration of electrolysis, practitioners were always on the lookout for an alternative. In 1885 Leopold Freund, pioneer of radiotherapy, applied x-rays to a patient with a large hairy growth covering most of her back. After 20 hours of x-ray exposure the hair fell out. When a report of the case was widely published in 1901, medical interest in treating unwanted hair with x-rays took off. In the 1920s, x-ray devices were popular as a fast, painless method of hair removal. It was another 10 to 15 years before the deadly consequences of this treatment became apparent when most clients contracted cancers and many died.

1923: Thermolysis Invented

Early Thermolysis Machine

Early Thermolysis Machine

Another treatment being developed in the 1920s was thermolysis. In this method, a high frequency alternating current was passed through a probe inserted into the follicle and the heat produced as the microwave current interacted with moisture in the follicle killed the hair.

This treatment was invented by Dr Henri Bordier of France but may have been attempted earlier by a Dr Eitner in Germany. It had few followers before the 1930s as the only way to produce high frequency electric currents at that time was with a device called a spark-gap. Just like a modern-day spark plug, a high frequency current was generated across an air-gap in a device that operators had to constantly adjust by monitoring the hissing noise and light flashes it made. This all changed with the invention of the vacuum tube and between 1930 and 1940 thermolysis, then called Ray Treatment or Diathermy, gradually took over from electrolysis.

Even though it was far less effective that electrolysis, thermolysis was much cheaper, much faster and inflicted less discomfort. It also brought about a lot of confusion in the marketplace. Since thermolysis treatment looked superficially the same as electrolysis, clients called it electrolysis and were mostly unaware that they were being treated by thermolysis.

1938: Blend Method Devised

1946 Blend Machine

1946 Blend Machine

Equipment manufacturers and owners of larger salon chains were well aware of the difference in effectiveness of thermolysis compared to the older electrolysis technique and in 1938 an electrologist, Henri St. Pierre and an engineer, Arthur Hinkel of the General Electric Company, developed a method which combined both techniques. Appropriately, they called this method Blend. Their idea was to combine the speed of thermolysis with the effectiveness of electrolysis – something that had remained wishful thinking until advances in electronics made the idea feasible in the late 1930s and practical in the 1940s.

The key to this method was claimed to lay in achieving just the right blend between the 2 techniques and different body areas required different combinations to be effective. This required a lot of training and St. Pierre and Hinkel would not sell their new blend machines to anyone who would not also take their training course. This meant the method spread slowly but those practitioners who took it up were thoroughly indoctrinated in the method and its “supposed” scientific basis. In 1968 Hinkel and Lind published their seminal work “Electrolysis, Thermolysis and the Blend” and the method finally escaped America eventually reaching England and Australia in the late 1970s. Long-term, the result worldwide was the almost complete abandonment of galvanic electrolysis and the relegation of thermolysis to general beauty salons lacking the skill to perform blend.

1970: Transistorisation and Complication

1980

“Computerised” Blend Machine

With the move in technology from valves to transistors then finally integrated circuit boards in the 1980s, electrolysis machines became smaller, more reliable and easier to use. On the other hand it gave full reign to the blend advocate’s obsession with customisation. Machines could now have fine control and rudimentary computerisation allowing the operator to choose from a pre-set series of control settings for every situation.

With the introduction of transistorised timers, current times could be controlled accurately to the fraction of a second. This led to the development of the flash method of thermolysis where a large current over a very short time period held the promise of greatly speeding the process. However, the fine line between a treatment that was too short and ineffective on the one hand and skin burns from a treatment that was too long on the other, was cut to almost nothing with flash. This resulted in far too many disaffected clients.

1980: Galvanic Revival

galvanic

1980 16 probe Galvanic Electolysis

The 1980s saw a revival in galvanic electrolysis. Hair removal practitioners read of the permanent results achieved by early galvanic machines – results they weren’t seeing with thermolysis or blend – and tried applying modern electronics to the age-old method. Led by Kay Lasker in Philadelphia, machines were developed with up to 16 probes. Each probe had its own timer and current regulator with the ability to gradually increase and decrease current at the beginning and end of each cycle. These machines were much safer and more comfortable for the client than multi-probe machines of the 1920s and up to 32 probes could be used at once, making the process almost as fast as thermolysis, but with the success rate of traditional electrolysis machines.

Through the hiatus in use of the galvanic method, much of the documentation on the technique, current settings, timers and aftercare had been lost forever. Kay and her associates had to reinvent procedure manuals from first principles relying on experimentation and trials. Much of the information that had survived had been set around basic battery-operated devices that shared little in common with the new mains powered transistorised machines now being developed.

1992: Galvanic Revival in Australia

In the early 1990s Noreen Colonelli travelled to the USA to further her knowledge of electrolysis and hair removal. She met Kay Lasker at a conference in Atlantic City and studied under her in Philadelphia. Soon she was back in Australia with one of Kay’s new machines and one from another member of the galvanic revival movement.

These were the first modern galvanic machines to reach Australia. They presented the first viable alternative to the single-needle thermolysis and blend machines that were then in use but they needed adaptation to work in Australia. It was not a simple task to calibrate the machines for Australian voltages or to unravel the potential of the new machines. Help came from some of Noreen’s clients who had backgrounds in engineering and medicine and were able to take a lot of the guesswork out of the process of making the machines safe, reliable and effective.

In the end, many believe Australia built a broader and more scientifically grounded hair removal knowledge base than America. This was in no small part thanks to Noreen’s work with the Mayo Clinic, the lecture series she presented around the world and the teaching manuals she developed which found their way into the beauty schools and colleges through her work establishing continuing education courses for electrologists in Australia.

1995: Laser

LaserWand

Laser wand

In the mid 1990s, just as galvanic electrolysis was becoming popular again, the first laser machines appeared. Like x-ray in the 1920s, laser was the fast, modern technology. Without the deadly side-effects of x-ray, it quickly swept away other forms of hair removal while competition and cheaper machines developed in China drove treatment costs even lower. Like thermolysis, laser worked by generating heat in the hair to kill it. Where thermolysis heated individual hairs via the moisture surrounding them, laser turned light into heat as it passed through light coloured skin and struck dark hair. It was able to do this several square centimetres at a time and not just follicle by follicle.

Laser treatment was still not without its limitations and side-effects. Without high colour contrast between skin and hair the method simply did not work and, with nothing else to absorb the laser energy, could result in skin burns if attempted on unsuitable skin. Also, like thermolysis and blend before it, laser was still not a permanent treatment for hair removal and hair would grow back within 12 months forcing clients to return regularly to keep unwanted hair at bay.

For clients with hormone-related hair growth, the consequences of laser treatment could be even worse. Excess androgen production combined with the stress of laser treatment, could trigger follicles growing vellus hair, the fine peach-fuzz hairs covering most of our body, to start producing dark, thick terminal hair leaving clients with more unwanted hair than before the laser treatment commenced.

New Discoveries

follicles for transplant

follicles for transplant

It wasn’t until the 1990s, just as laser was being introduced, that scientists finally documented the complete hair growth cycle when they discovered the function of the bulge. For a century and a half clinicians and scientists had concentrated on the function of the hair bulb at the base of the follicle in encouraging or discouraging hair growth. Now it was found that the bulb is grown and nurtured at the beginning of each growth cycle from stem cells released from the bulge. To a large extent this explained why treatments such as thermolysis, blend and laser, which could be shown to kill the hair bulb, could only permanently prevent hair growth on 10% of treated hairs while galvanic electrolysis permanently prevented hair growth in 90-95% of treated hairs. Electrolysis caused lye to form up the entire length of the follicle and inadvertently destroyed the bulge in the process. Laser, thermolysis and blend were only affecting the bulge during its most vulnerable period – in the growth stage: a stage in the hair cycle in which only 10% of hairs are active at any one time.

Fortunately some galvanic operators survived the laser hair removal “craze” and a growing stream of “laser refugees” encouraged a growing number of therapists to relearn the skill of galvanic electrolysis.

2007: US FDA Reconfirms Electrolysis the Only Permanent Hair Removal Method

The United States Food and Drug Administration through its Center for Devices and Radiological Health regulates electrolysis equipment, lasers and other medical equipment. Amid the growing popularity of laser hair removal and the extravagant claims of manufacturers and clinics, the FDA reiterated its position that only electrolysis can permanently remove hair and warned laser clinics against making such claims.

The FDA Consumer Health Information Bulletin of 27 June 2007 states:

“The U.S. Food and Drug Administration (FDA) recognizes electrology as providing permanent hair removal. The FDA identification in Title 21, CFR, Sec. 878.5350 for needle-type epilators is: “a device intended to remove the hair by destroying the dermal papilla of a hair”. As no other device for hair removal has the unique identification of “destroying the dermal papilla of a hair”, only electrologists are allowed to claim permanent hair removal in their advertising”.